PRECLUDE® Pericardial Membrane for the management of perforated corneal ulcer in patients with systemic autoimmune inflammation

Pahor, Artur; Pahor, Dušica

doi:10.1007/s00717-014-0227-4

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…Die Behandlung des perforierten Hornhautulkus mit einer Membran aus e-PTFE könnte die Methode der Wahl sein, da das Angebot an gut erhaltener Hornhaut sehr begrenzt ist und in manchen Fällen ein großes Risiko für Abstoßungsgefahr besteht. Nach unserem Wissen gibt es nur 5 Berichte über die Verwendung der Membran aus e-PTFE für die Behandlung des tiefen perforierten Hornhautulkus [28][29][30][31][32]. Huang und Kollegen stellten durch 3 Fälle fest, dass die Deckung mit Gore-Tex für perforierte Augen nicht geeignet ist, und sie sollte nur dann verwendet werden, wenn kein anderes Transplantat zur Verfügung steht [29].…”

Section: Diskussion !unclassified

“…PRECLUDE ® Pericardial Membrane ist bei den Augenchirurgen nicht weit verbreitet. Es gibt nur 2 Berichte über die Verwendung des Materials aus e-PTFE zur vorübergehenden Versorgung bei tiefen Hornhautulzerationen oder Hornhautperforationen [28][29][30][31][32]. 1991 wurde die Membran aus e-PTFE zum ersten Mal von Legeais und seinen Kollegen bei einer Hornhautperforation verwendet [28].…”

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E-PTFE Membran für die Behandlung von perforiertem Hornhautulkus

Pahor

2016

Klin Monatsbl Augenheilkd

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To present the surgical management of perforated corneal ulcer using PRECLUDE® Pericardial Membrane, composed of expanded polytetrafluoroethylene (e-PTFE; GORE-TEX®), as an alternative surgical procedure in patients at high risk of graft rejections and to evaluate side effects for a prolonged period. The study included all patients who were admitted to our department and underwent surgical repair of perforated corneal ulcer with the e-PTFE membrane between 2010 and 2015. In total, 8 patients (8 eyes) were enrolled. Medical records of all patients were retrospectively reviewed. The operation was performed under peribulbar anaesthesia. Non-absorbable, microporous, watertight 0.1 mm thick e-PTFE membrane was used to close the corneal ulcer. The membrane was cut to overlap the defect adequately and to achieve the desired tissue attachment without preparing the conjunctiva or superficial trephination of the cornea. The membrane was fixed to the healthy cornea with several non-absorbable sutures (Prolene® 10.0), in order to achieve the proper stress without wrinkling. Five of 8 patients were treated for systemic immunological diseases. Sjögren's syndrome was diagnosed in 2 patients, granulomatosis with polyangiitis in one, vasculitis with a history of previous sclerokeratitis in one and systemic lupus erythematosus in one. In 2 patients, corneal perforation was observed as a complication of corneal infection and in one patient as a late complication of a severe chemical burn. Corneal perforations were successfully covered with e-PTFE membrane in all patients. E-PTFE membrane was well tolerated in all patients and the eye was always preserved. After 3 to 4 months, the membrane was removed in 7 patients. The underlying cornea was thin, firm, stable and vascularised. In one patient with Sjögren's syndrome, the e-PTFE membrane is still in place. Surgical management of perforated corneal ulcer using E-PTFE membrane may be the method of choice for eye preservation or for delayed corneal transplantation. Our results confirmed that the procedure is safe and effective, especially in high risk patients. After removing the membrane, penetrating keratoplasty can be performed as a definitive treatment in all eyes where an improvement in visual acuity is expected.

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